Individual provider Active NPI

Matthew Kovalchick, DPT

  • Physical Therapist
  • Allentown, PA
National Provider Identifier
1043855901
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT027817 Issued in PA
Practice address
1901 Hamilton St
Allentown, PA 18104-6459
Phone
(484) 426-2930
Fax
(484) 426-2933
NPI assigned
Nov 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT027817 PA Primary

Addresses

Primary practice location

1901 Hamilton St
Allentown, PA 18104-6459

Mailing address

1901 Hamilton St
Allentown, PA 18104-6459
Phone (484) 426-2930

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address matthew.kovalchick@sluhn.org St. Luke's Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116004420 CA Practitioner - Physical Therapist in Private Practice 2567814486 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT027817PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jan 4, 2024 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1043855901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 HAMILTON ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181046459",
            "telephone_number": "484-426-2930",
            "fax_number": "484-426-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 HAMILTON ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181046459",
            "telephone_number": "484-426-2930",
            "fax_number": "484-426-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALCHICK",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-14",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT027817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.kovalchick@sluhn.org",
            "affiliation": "Y",
            "affiliationName": "St. Luke's Hospital",
            "address_1": "1901 Hamilton St",
            "city": "Allentown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "181046459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.